Heartburn (Dyspepsia)

Heartburn and dyspepsia (dis-PEP-see-a) are two terms used interchangeably to describe a burning feeling in the chest and other symptoms caused by problems digesting food.

Does the Heart Burn When Someone Has Heartburn?

Sarah's grandfather always comes to her house for Sunday dinner. For several weeks in a row, he seemed uncomfortable after eating and did not lie down for his usual nap. Sarah heard him talking to her father about heartburn. This scared Sarah, who thought that her grandfather was having heart problems.

When Sarah asked her grandfather what was wrong with his heart, he explained that people with heartburn, also called acid indigestion, often complain of a burning feeling in the chest, close to where the heart is located. But heartburn usually does not have anything to do with the heart. The discomfort in the chest and throat occurs when the contents of the stomach, which includes acid and digestive enzymes ^* , moves backward and up into the esophagus, or food pipe. This stomach juice escapes when the muscular valve between the stomach and esophagus relaxes. The acidic juice irritates the lining of the esophagus and results in a burning feeling and a bitter, sour taste in the throat and mouth. Heartburn usually occurs after a meal and can last for several hours. It is often worse when lying down.

What Is Heartburn?

Some people use the word "dyspepsia" to describe the symptoms experienced by Sarah's grandfather. Dyspepsia comes from the Greek words for bad digestion, and it covers a wide range of stomach ailments, including stomachache, heartburn, nausea, gas, pain, belching, loss of appetite, changes in bowel habits, and indigestion in general.

Heartburn occurs when the contents of the stomach move backward through the muscular valve called the lower esophageal sphincter and up into the esophagus. The stomach's acid and digestive enzymes irritate the lining of the esophagus, causing a burning feeling in the chest and a bitter, sour taste in the throat and mouth.

More than 60 million adults in the United States experience these stomach problems at least once a month, and pregnant women and elderly people especially are prone to them. Children usually do not have heartburn. They might feel indigestion, though, after eating too many hot dogs. Stomach ailments are some of the most common reasons why people visit their doctors.

By themselves, dyspepsia and heartburn are not really diseases. They are just uncomfortable symptoms people get, usually because they ate too much or are feeling stressed, anxious, or depressed. However, people who keep getting the symptoms, or who get them often, should see their doctors promptly, because heartburn and dyspepsia may be signs of other disorders, including:

• Appendicitis is inflammation of the appendix, a small tube connected to the large intestine.
• Peptic ulcer is a sore in the lining of the stomach or small intestine.
• Hiatal hernia occurs when part of the stomach pushes up into the chest through an opening in the diaphragm, the muscle between the chest and the abdomen.
• Lactose intolerance is a problem in digesting lactose, a sugar found in milk and other dairy products.
• Gallbladder disease is inflammation or blockage in the gallbladder, a small organ of the digestive system.
• Gastroesophageal (gas-tro-e-sof-a-JEE-al) reflux disease (GERD) is a digestive condition in which the muscular valve (lower esophageal sphincter) between the esophagus and stomach does not work properly, allowing stomach acid to flow backward into the esophagus.
• True heart pain, which is also called angina pectoris (an-JY-na PEK-tor-is).

How Is Heartburn Diagnosed, Treated, and Prevented?

Doctors use several different tests to diagnose heartburn. If they can rule out other diseases, as was true for Sarah's grandfather, then over-the-counter antacid medications, dietary changes, and lifestyle changes can help most people feel better.

Guidelines for preventing heartburn include:

• avoiding chocolate, coffee, and alcohol
• avoiding greasy or spicy foods
• quitting smoking
• losing weight
• not eating right before bed
• finding ways to deal with stress.